Individual
DR. MARISSA ANN WISDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
401 N 9TH ST, BISMARCK, ND 58501-4530
(701) 530-6000
(701) 530-6422
Mailing address
401 N 9TH ST, BISMARCK, ND 58501-4530
(701) 530-6000
(701) 530-6422
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
11239
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11122
—
ND
01
—
1972713337
BCBS PROVIDER #
ND
Enumeration date
05/23/2007
Last updated
06/06/2023
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